Francis J, Francis D, Larson L, Helms E, Garcia M
Walt Disney Memorial Cancer Institute at Florida Hospital, Orlando, FL 32804, USA.
Platelets. 1999;10(2-3):132-6. doi: 10.1080/09537109976194.
The bleeding time (BT) is widely used in clinical medicine as a screening test of platelet function, although its deficiencies in such a role are well recognized. The Platelet Function Analyzer (PFA)-100 measures the ability of platelets activated in a high-shear environment to occlude an aperture in a membrane treated with collagen and epinephrine (CEPI) or collagen and ADP (CADP). The time taken for flow across the membrane to stop (closure time) is recorded. This study compared the PFA-100 with the BT as a screening test of platelet dysfunction in 113 hospital inpatients. The PFA-100 test was performed initially using the CEPI cartridge; CADP tests were performed on those with abnormal (> 163 s) CEPI closure times. Whole blood platelet aggregation studies and chart review were performed on patients in whom the BT and PFA-100 results did not agree.Abnormal bleeding times and PFA-100 results were obtained in 20.4% and 35.4% of patients, respectively. The results of BT and PFA-100 agreed in 74.3% of patients. Of the 29 patients in whom the BT and PFA-100 results were discordant, whole blood platelet aggregation studies supported the PFA-100 result in 25 (86.2%). The PFA-100 was more sensitive to aspirin-induced platelet dysfunction and was more rapidly and cheaply performed than the BT. Since the PFA-100 test reflects platelet function better than the BT, we conclude that this test could replace the BT as a first-line screening test for platelet dysfunction in clinical practice.
出血时间（BT）在临床医学中被广泛用作血小板功能的筛查试验，尽管其在这一作用方面的不足已得到充分认识。血小板功能分析仪（PFA）-100可测量在高剪切环境中被激活的血小板封堵经胶原和肾上腺素（CEPI）或胶原和二磷酸腺苷（CADP）处理的膜上小孔的能力。记录血液流经膜直至停止（封闭时间）所需的时间。本研究比较了PFA-100与BT作为113例住院患者血小板功能障碍筛查试验的情况。最初使用CEPI检测卡进行PFA-100检测；对CEPI封闭时间异常（>163秒）的患者进行CADP检测。对BT和PFA-100结果不一致的患者进行全血血小板聚集研究并查阅病历。分别有20.4%和35.4%的患者出血时间和PFA-100结果异常。BT和PFA-100结果在74.3%的患者中一致。在BT和PFA-100结果不一致的29例患者中，全血血小板聚集研究支持PFA-100结果的有25例（86.2%）。PFA-100对阿司匹林诱导的血小板功能障碍更敏感，且比BT操作更快、成本更低。由于PFA-100试验比BT能更好地反映血小板功能，我们得出结论，该试验可在临床实践中取代BT作为血小板功能障碍的一线筛查试验。
